title: Competence of general practitioners in giving advice about changes in lifestyle to hypertensive patients.
abstract: OBJECTIVE
  The aim of this study was to assess the advice about lifestyle changes that general practitioners (GPs) gave hypertensive patients with different levels of cardiovascular risk.
  
  
  METHODS
  and
  
  
  METHODS
  A stratified sample of primary health care physicians in Poland completed a questionnaire consisting of 8 case vignettes that differed with regard to 3 major variables: 1) the level of blood pressure (high-normal blood pressure or grade 2 hypertension), 2) the presence of selected risk factors such as smoking and obesity, and 3) diabetes mellitus. The case vignettes were followed by a series of open questions.
  
  
  RESULTS
  The response rate was 65% (125/192 selected physicians responded). The mean age was 45.2 +/- 8.1 years, and the average length of professional experience in primary care was 14.7 +/- 9.3 years. For 1000 potential clinical decisions considered, all expected pieces of advice were given in 18.3% of situations, whereas in 11.5%, no advice concerning nonpharmacological treatment was provided. In 70.2% of situations, Polish primary health physicians gave incomplete advice. The average percentage of expected advice in all cases was 57.2% +/- 30.8%. The presence of hypertension along with other risk factors of cardiovascular disease was associated with better quality advice (P < 0.001), but the coexistence of diabetes mellitus had opposite consequences (P<0.001).
  
  
  CONCLUSIONS
  Despite the existence of well-known guidelines for the treatment of hypertension in Poland, GPs rarely give complete lifestyle advice, particularly for patients with cardiovascular risk due to high-normal blood pressure and diabetes.
authors.affiliation: Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland. mmwindak@cyf-kr.edu.pl
authors.forename: Adam
authors.initials: A
authors.lastname: Windak
authors.forename: Barbara
authors.initials: B
authors.lastname: Gryglewska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Tomasik
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grodzicki
mesh_terms: D000367:Age Factors; D002983:Clinical Competence; D003142:Communication; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D011044:Poland; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016540:Smoking Cessation; D015431:Weight Loss